Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA.
Catheter Cardiovasc Interv. 2024 Oct;104(4):790-799. doi: 10.1002/ccd.31183. Epub 2024 Aug 21.
A large proportion of patients referred for transcatheter tricuspid valve intervention (TTVI) will have the presence of a cardiac implantable electronic device (CIED). In such patients, surgical correction of tricuspid regurgitation (TR) is associated with high rates of morbidity and mortality. Transvenous lead extraction (TLE) could potentially ameliorate CIED-induced TR; however, it carries inherent risks and frequently does not result in TR improvement. As multiple TTVI devices are in trial to gain regulatory approval, understanding which therapy is most appropriate among patients with a CIED is essential. This review centers on the nonsurgical treatment, including TLE and transcatheter tricuspid valve repair and replacement options, aimed at enhancing outcomes in patients with TR who also have concurrent CIEDs.
很大一部分接受经导管三尖瓣介入治疗(TTVI)的患者将存在心脏植入式电子设备(CIED)。在这些患者中,三尖瓣反流(TR)的手术矫正与高发病率和死亡率相关。经静脉导线拔除术(TLE)可能改善 CIED 引起的 TR;然而,它存在固有风险,并且通常不会导致 TR 改善。由于多个 TTVI 设备正在进行临床试验以获得监管部门的批准,因此了解在患有 CIED 的患者中哪种治疗方法最合适是至关重要的。本综述侧重于非手术治疗,包括 TLE 和经导管三尖瓣修复和置换选择,旨在提高同时患有 TR 和 CIED 的患者的治疗效果。